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Elevated liver enzymes please help..UPDATED

keystone

Posts: 134
Joined: Dec 2010

Jul 01, 2011 - 10:06 am

My husband just met with the oncologist yesterday. He has completed 2 FOLFOX teatments and has had the normal side effects but the Dr. informed us that his liver enzyme were elevated. He did not say which one nor the actual count (said it was not real high). He was on a high dose of Xeloda before surgery without any concerns relating with blood counts. I have looked at many threads on this but I'm wondering which FOLFOX drug is usually the culprit of this. It does not look like "normally" this is a sign of progression of cancer and we really have no reason to believe his cancer has spread. He is stage IIIa with post surgical path reports only showing 1/22 lymph nodes involved. If anyone could help me on this I sure would appreciate it.

from a page at the Mayo Clinic website:
"Elevated liver enzymes may be discovered during routine blood testing. In most cases, liver enzyme levels are only mildly and temporarily elevated. Most of the time, elevated liver enzymes don't signal a chronic, serious liver problem."

"Elevated liver enzymes may indicate inflammation or damage to cells in the liver. Inflamed or injured liver cells leak higher than normal amounts of certain chemicals, including liver enzymes, into the bloodstream, which can result in elevated liver enzymes on blood tests."

Not to be an alarmist, but elevated liver enzymes was initially how I found out I had cancer. I had no other symptoms.

Probably it's from the FOLFOX. Did the oncologist suggest what might be the cause? You can worry yourself sick with only partial information and then using the internet to try to figure it out.
-phil

Elevated liver enzymes are common when on chemotherapy regimens. My liver enzymes have been elevated since treatment and they are still are even though my last chemo treatment was November 2009. The liver enzymes the doctor looks at are the ALT, AST, Alkaline Phosphatase and Bilirubin.

At http://www.labtestsonline.org/understanding/analytes/alt/test.html you can review more information about ALT as well as link to pages specific to the other liver enzymes.

If your doctor isn't too concerned with the numbers, don't be. I used to track my numbers on a spreadsheet and be very concerned with them but as of right now my doctor isn't too concerned, so I try not to worry either.

I know both your husband and yourself will though, hard not too. If your oncologist isn't concerned, ie they don't want to do further tests, scan etc then it's ok. They will be monitoring things though which is good. I think no one on chemo has escaped their liver levels being elevated, i know i didn't even after treatment finished. Main thing is that they keep it monitored. About milk thistle that is great, but I would advise you to check with your oncologist that it is ok to take while on chemo. I know we all try different supplements while on chemo, i only stuck with one multi vitamin which my oncologist was ok with. Garlic, separate vitamins etc he said no. But my family made sure I kept up with my fruits etc, everyone is different you will find the right balance for you.

That was how I found out I had a problem from a regular blood test that showed elevated liver enzymes (lucky for me). The tumour from the gallbladder had penetrated the liver. My oncologist like someone else's on an earlier post took me off milk thistle while on chemo because he had a patient who experienced severely elevated liver enzymes while on milk thistle. So for now I'll obey the oncologist as he seems to be in charge of my life right now. There are excellent reasons to take it too. Obviously more research needed and bodies do differ.
Cheryl

I had elevated Liver tests with my highest at 244 and then the Oncologist lowered the chemo to 80% for #11, #12 Folfox. At my 3 months post chemo appointment my levels are approaching the normal range and I am NED. Prayers for your husband as well.
NB

My oncologist told me to let him worry about the numbers. I did watch them and ask questions, but never questioned his methods.

Let your doctor worry about the numbers. If you do not feel that confident in your Oncologist, then find a different one.

I believe we need to be proactive in our health. At the same time we do not have all the education, nor experience to interpret all of the numbers. I asked plenty of questions during chemo, but at the end trusted my Oncologist.

I think we need to be informed patients but there is a line where being informed and having a ton of information that I can not process or understand. I played that game in the beginning and worried like crazy. Now, I get what information I need and try not to play the numbers game.
I like your comment "Let your doctor worry about the numbers. If you do not feel that confident in your Oncologist, then find a different one."
-phil

Thanks, Mike and Phil and all: Good advice. I want to be informed but not overloaded - I need some energy and mind space to concentrate on my family and friends. But I'd like to know my CEA number (I can't help it!!!!!). Haven't had that test just CA19 and CA125. And they were well within normal ranges.
Cheryl

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